Impact of COVID-19 on the Distribution of Pathogenic Bacteria in the
Lower Respiratory Tract of the Elderly
Abstract
Background: To investigate the distribution of bacterial pathogens of
lower respiratory tract infection (LRTI) in hospitalized elderly
patients during the COVID-19 epidemic and to explore the influence of
COVID-19 on the distribution of bacterial pathogens, in order to provide
guidance for clinical diagnosis. Methods: Specimens of sputum from
elderly LRTIs patients at Fuding Hospital of China were collected from
October 2022 to January 2023. Cultures and identification were done, and
RT-PCR was employed to detect SARS-Cov-2 nucleic acid. Results: A total
of 195 isolates were characterized in 163 sputum samples of consecutive
hospitalized elderly patients, of which 11.3% were Gram-positive
bacteria and 88.7% Gram-negative. The top of frequently isolated
pathogens were Klebsiella pneumonia (30.3%), Pseudomonas aeruginosa
(19.0%), Acinetobacter baumannii (12.8%), Stenotrophomonas maltophili,
(7.7%), Escherichia coli (7.2%). According to the results of novel
coronavirus nucleic acid detection, the 163 patients were divided into
COVID-19 group and non-COVID control (CNT) group. The comparison of
bacterial distribution between the groups revealed that Stenotrophomonas
maltophilia was lower in the COVID-19 than in the CNT group, while
Acinetobacter baumannii was higher in the COVID-19 group, and the
difference was statistically significant (P < 0.05).
Conclusion: The major bacteria identified in sputum culture of
hospitalized elderly patients were Klebsiella pneumonia, Pseudomonas
aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, and
Escherichia coli. Furthermore, the distribution of Stenotrophomonas
maltophilia and Acinetobacter baumannii between the COVID-19 and CNT
groups was found to be significantly different (P< 0.05),
while there were no significant differences in the distribution of other
bacteria.